ANTERIOR SCOLIOSIS CORRECTION (ASC): WHAT IS IT?
June, 10, 2020
The term ASC has been popularized by the US surgeon Darryl Antonacci MD. He improved the previously described VBT technique in order to treat patients with either scoliosis larger than 60°, stiff curves (which typically correct to less than 30° in side bending) and scoliosis in patients who have completed or mostly completed the spinal growth. ASC builds on the previous concepts of VBT, improving it.
To say it in few words, ASC is more powerful and can be used in most scoliosis cases, differently from VBT, which can be used in as little as 10% of the scoliosis patients (those who have relatively small and flexible curves, and are still growing).
Dr Berjano was trained in the ASC technique by its creator, Dr Antonacci in 2018, and is currently the only surgeon based in Europe who is using Dr Antonacci's technique the technique, trained by its inventor.
ASC IMPROVES LORDOSIS AND KYPHOSIS
July, 10, 2020
Though the best know aspect of scoliosis is the coronal deformity (it is the inclination as seen from the front), the shape of the spine seen from the side is extremely important for the patient's health. Scoliosis patients have typically a reduction in both thoracic kyphosis and lumbar lordosis. Thoracic kyphosis is important for two reasons: it creates space in the chest for the lungs and the heart (you don't need more explanations to know how important it is) and relaxes the neck into its natural alignment (lordosis). In fact, many scoliosis patients have the neck in kyphosis, which overloads the cervical discs and can cause development of neck pain in the adult life. Lumbar lordosis allows for a relaxed standing position. In fact, patients with loss of the lumbar lordosis are more likely to suffer from back pain and lumbar disc degeneration. In this example you can see how both the thoracic kyphosis and the lumbar lordosis have been increased after anterior scoliosis correction
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DR PEDRO BERJANO MD, PHD
ISTITUTO ORTOPEDICO GALEAZZI
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Our team incorporates the best innovations and an impressive experience in the treatment of scoliosis. State-of-art spinal cord neuromonitoring, advanced hemodynamics control, surgery performed with visual magnification, meticulous handling of blood and impedance meters to assist screw insertion make of scoliosis correction a safe and predictable process
ASC OR VBT
Two different techniques that preserve spinal motion
Vertebral body tethering (VBT) is the "oldest" technique. It uses a tether (cord) with the aim of using the remaining growth of the spine to correct over time the scoliosis.
Anterior scoliosis correction (ASC) was introduced by Drs Antonacci and Betz to extend the indication of scoliosis correction with cords to patients who have more severe curves or have completed (or almost) their spinal growth
BACK TO SPORTS
Motion-preserving surgery for a more normal life
Scoliosis correction with cords avoids the limitations imposed by a stiff spine to patients. Rather than returning or not to sports (fusion surgery is not incompatible with sports) the difference is the quality of motion for the rest of the life, and the rate of wear of the remaining mobile segments. Vertebral body tethering (VBT) and anterior scoliosis correction (ASC) patients can return to sports 6 weeks after surgery
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